Ambulatory Coding Support Specialist II- Full Time Days

Cape Fear Valley Health System; United States; On-site; USD 75,000 - 110,000; Full time

Job summary

Cape Fear Valley Health System is seeking a professional coder within Physician Financial Services to ensure precise CPT, ICD-10, and modifiers aligned with documentation. Collaborate with CFV Medical Group and Physician Revenue Cycle to improve coding accuracy and reduce denials.

The role emphasizes education of providers and staff, with a focus on maintaining documentation standards and optimizing revenue in a busy clinical setting at Cape Fear Valley Medical Center and related facilities.

Qualifications

• Bachelor’s degree in health information management or 8 years coding experience in lieu of degree.
• CPC, CPMA, RHIA, RHIT, CCS or CCS-P or other equivalent credentials required.

Responsibilities

• Review and ensure accurate CPT, ICD-10, and modifier usage on claims.
• Educate and develop professional coding within CFV Medical Group and Physician Business Office.
• Assist in reducing coding denials and improve front-end edits.

Skills

Medical terminology understanding

ICD-CM coding principles

Communication skills

Analytical and organizational skills

Judgment for code assignment

Adaptability

Education

Bachelor’s degree in health information management

8 years coding experience in lieu of degree

CPC/CPMA/RHIA/RHIT/CCS/CCS-P

Job description

Facility Cape Fear Valley Medical Center Location Fayetteville, North Carolina Department Physician Financial Services Job Family Professional Work Shift Days (United States of America)

Summary

Thoroughly review medical records to code specifically and accurately those conditions or diagnoses that were treated or affected the patient's plan of care. Verify each medical record reviewed contains appropriate documentation to justify the selected CPT, HCPCS, modifiers and ICD-10 codes. Work with Physician Billing Office and physician practices to improve code assignment, resolve and prevent edits and review for documentation deficiencies. Help educate and develop professional coding within the CFV Medical Group and Physician Business Office.

Major Job Functions

• Work closely with CFV Medical Group/Ambulatory practices and Physician Revenue Cycle/Business Office to ensure CPT, ICD-10 and modifier usage is accurate on claims
• Assist overall goal to reduce coding related denials and improve coding related editing
• Assist and advise Business Office on coding related denials by reviewing medical record documentation to make corrections and/or adjustments to claims as needed
• Assess NCCI and CCI edits as necessary to apply appropriate modifiers and work closely with Business Office to improve front end editing as needed
• Assist in identifying revenue opportunities within the Medical Group through the creation of Job Aids and instructional/educational materials
• Provide education and feedback to providers, coding staff and billing staff as needed to ensure documentation requirements are maintained and revenue is optimized
• Analyze providers’ coding profiles (E/M coding distribution) and documentation patterns to ensure that providers are confident with code selection and documentation requirements
• Support the development of professional coders and coding standards within the Medical Group and Business Office
• Coordinate with Revenue Integrity on identifying documentation gaps, potential revenue opportunities and supports documentation improvement efforts overall
• Make management team aware of problem issues, negative physician communication and/or other influences that impact effectiveness of job performance
• Other duties as assigned

Minimum Qualifications

Education and Formal Training:

• Bachelor’s degree in health information management required OR 8 years’ coding experience in lieu of degree required
• CPC, CPMA, RHIA, RHIT, CCS or CCS-P or other equivalent credentials required

Work Experience: None

Knowledge, Skills, and Abilities Required:

• Understanding of medical terminology, anatomy and physiology and familiarity with medical record content
• In-depth knowledge of ICD-CM coding principles, LCDs/NCDs, HCCS and other coding conventions for professional documentation and claim submission
• Uses tact and diplomacy in communications with physicians and other CFVH personnel
• Excellent communication skills
• High degree of interpretation, analysis, planning, coordination, and organization of information
• Decisions require intense mental effort and consideration of reimbursement ramifications
• Utilize past experiences, practices and organization to accomplish goals
• Assign accurate codes using good judgment in a timely manner within broad guidelines
• Must be flexible
• Ability to concentrate in a busy, noisy, and crowded environment with demands and interruptions 75% of the time

Physical Requirements:

• Job requires computer literacy
• Speech, sight and hearing required as incumbent must work independently in effectively training and monitoring coding functions
• Long periods of sitting
• Near visual acuity required
• Motor coordination required to operate computer

Required Licenses and Certifications CCS - American Health Information Management Association

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity

For exceptional healthcare come to Cape Fear Valley Health where caring employees are committed to integrity, patient-centeredness and excellence throughout the entire healthcare process. At Cape Fear Valley Health, our goal is to improve the quality of every life we touch. Our diverse team of doctors, nurses and staff work together to create a better experience for every patient, every time. Cape Fear Valley is a 950-bed, 8-hospital regional health system, the 8th largest in North Carolina, with more than 1 million inpatient and outpatients annually. A private not-for-profit organization with over 7,000 employees and 850 physicians. Our employees and physicians proudly serve a seven-county region of southeastern North Carolina, including Fayetteville, Fort Bragg, Hope Mills, Raeford, Lumberton, Elizabethtown, Clinton, Lillington, Dunn and beyond. Our medical facilities include Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Cape Fear Valley Rehabilitation Center, Behavioral Health Care, Bladen County Hospital, Hoke Hospital, Central Harnett Hospital, Betsy Johnson Hospital, as well as more than 60 medical offices and specialty care clinics spread throughout the Cape Fear region.